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Incorporate Sleep Evaluation into Routine Medical Care

CHICAGO - Sleep is an integral part of health, and assessment of sleep habits should be a standard part of medical care//, according to an editorial in the September 18 issue of Archives of Internal Medicine , one of the JAMA/Archives journals. The issue is devoted to studies of sleep and health.

"The theme that emerges throughout this issue is that sleep serves as an indicator of health and quality of life and therefore is highly and directly relevant to the practice of medicine," write guest editor Phyllis C. Zee, M.D., Ph.D., and Fred W. Turek, Ph.D., of Northwestern University Feinberg School of Medicine, Chicago.

"Indeed, numerous studies have recently shown that sleep disorders are often comorbid with a broad range of medical and psychiatric conditions and also have a negative impact on health, mood and quality of life," they continue. "Increasing evidence also points to a bidirectional relationship between sleep and health; that is, sleep disturbances contribute to the development of or increase the severity of various medical and psychiatric disorders, and these same disorders result in poor sleep quality."

Research results published in this issue of Archives of Internal Medicine "further our understanding of the relationship of sleep and health," Drs. Zee and Turek write. Studies appearing in this issue find that:

Fewer hours of sleep may contribute to poor health in young adults, according to an international survey of more than 17,000 university students
Those in rural areas who sleep fewer hours appear to have a higher average body mass index
The immune system may play a role in narcolepsy, a disorder marked by a sudden and uncontrollable urge to sleep
Children with chronic illnesses, especially those on ventilators, tend to have parents with disrupted sleep
The immune system may be affected by a lack of sleep, altering blood chemistry in a way that potentially contributes to inflammation and a variety of diseases
Over the past decade, it has become apparent that voluntarily limited sleep, as well as sleep disorders such as insomnia and restless legs syndrome, can negatively affect overall health-a connection emphasized by the increasing legitimacy of sleep medicine as a specialty. In addition, medications used to treat a number of physical and psychiatric disorders can affect sleep, making evaluation for sleep problems essential for those following such regimens. "At the very least, assessment of sleep quantity and quality should be integrated into the routine review of systems," Drs. Zee and Turek conclude. "Sleep is an indicator of health, and sufficient sleep quantity and good quality should be considered as an essential component of a healthy lifestyle, as much as exercise and nutrition."
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